February 8, 2021
Do you have a strong family history of cardiovascular problems? Take heart—you’re not doomed by your genetics.
Every time you see a new doctor or fill out a health information questionnaire, you dread the question.
“Do you have a family history of heart disease?”
You answer yes and wonder when—not if—you will develop it yourself. After all, you know heart disease is hereditary. Medicine has known that for a while.
There are many genetic components to heart disease, says Pradyumna “Prad” Tummala, MD, cardiology section chief at Northside Hospital, and they include those that affect the heart muscle (making it thickened, enlarged or weak), the circulatory system (causing blockages, weak spots or tears in arteries) and the electrical system (leading to faulty heart rhythms).
More than 50 known genetic markers are associated with heart disease. Having some of those markers makes it more likely that a person will have high cholesterol; other markers increase the risk of high blood pressure, diabetes or obesity. All of them increase the risk of heart disease to some degree.
Heart disease also tends to run in families because of shared lifestyle habits. In other words, if your parents ate a high-sodium, high-fat, high-sugar diet, you’re more likely to eat the same.
There’s also more to heart disease risk than just family history.
Just because your family history puts you at greater risk of heart disease doesn’t mean you’ll develop it.
“There are a lot of things we can do to overcome genetics,” Dr. Tummala says. “If your family has a history of having heart attacks and heart blockages, typically we screen for all the risk factors that we know. That can include high cholesterol, high blood pressure, looking at your weight, diabetes, making sure you don’t smoke. We can alter a lot of these risk factors to really minimize your risk of developing significant heart disease.”
In fact, a 2016 study in the New England Journal of Medicine (NEJM) showed that lifestyle factors can overrule heredity. The study found that making even a relatively modest effort to live healthfully can cut your risk of heart disease by up to 50 percent.
The study looked at four factors and their effect on heart disease risk: not smoking, maintaining a body mass index of less than 30, getting regular physical activity and eating a healthy diet.
“There is a large lifestyle component to heart disease. Exercise is very important, and light to moderate exercise is just as good as vigorous exercise,” Dr. Tummala says, explaining that moderate exercise is anything that has you working up a sweat and breathing a bit hard. A regular regimen of 30 minutes a day, three to five times a week, will do the trick.
Although the NEJM study didn’t look at the following factors, research suggests that they, too, are beneficial in reducing the risk of heart disease:
